Atlantic Retina Consultants

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

Legal business name

ATLANTIC RETINA CONSULTANTS

Practice address

175 E Nasa Blvd Ste 201
Melbourne, FL 32901-1998

Phone

(321) 999-7456

NPI assigned

Mar 11, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hetal Vaishnav, MDNPI 1750319331

Title

Owner

Phone

(321) 999-7456

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: retina@atlanticeyegroup.com

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hetal Dinesh Vaishnav, MD

  • Ophthalmology Physician
  • Melbourne, FL
  • NPI 1750319331

  FL

  Medicare reassignment Care Compare group Authorized official
• Gary J Ganiban, M.D.

  • Ophthalmology Physician
  • Melbourne, FL
  • NPI 1306837281

  FL

  Medicare reassignment Care Compare group
• Michael N Mandese, O.D.

  • Optometrist
  • Melbourne, FL
  • NPI 1720079577
  NPD (past)
• Eric Robert Straut, O.D.

  • Optometrist
  • Melbourne, FL
  • NPI 1194158337
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1649928490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560095",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E NASA BLVD STE 201",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011998",
            "telephone_number": "321-999-7456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1709 Garden St",
            "address_purpose": "LOCATION",
            "city": "Titusville",
            "state": "FL",
            "postal_code": "327965002",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5055 Babcock St NE Ste 6",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329054673",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 S Woods Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329553262",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 N Courtenay Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329533495",
            "country_code": "US",
            "telephone_number": "321-999-7456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ATLANTIC RETINA CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "VAISHNAV",
        "authorized_official_first_name": "HETAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-999-7456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Retina@AtlanticEyeGroup.com",
            "affiliation": "N",
            "address_1": "175 E Nasa Blvd Ste 201",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329011998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Melbourne, FL
• Retina Specialist (Ophthalmology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.